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    "I could cope so much better if I could just get a good night's sleep" : maternal sleep and mental health from early pregnancy to three years post birth : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Public Health at Massey University, Wellington, New Zealand
    (Massey University, 2020) Ladyman, Clare Iona
    Healthy sleep is vital to health and wellbeing at all life stages. But for many women, achieving restorative and satisfying sleep consistently throughout pregnancy is challenging. Because vulnerability to experiencing depressive symptoms increases with poor sleep and poor sleep influences the development and trajectory of depressive symptoms, sleep is an important and modifiable factor in the prevention and treatment of depression. Pregnancy is also considered a key teachable life stage as mothers wish to be healthy in order to protect their unborn baby. Yet research investigating non-pharmacological sleep education interventions for preventing perinatal depression is scarce. This thesis comprises three studies that investigate the relationship between maternal sleep health and depression. It presents findings from a scoped review examining sleep health throughout pregnancy; a longitudinal analysis of depression trajectories from late pregnancy to three years post-birth and the association of different sleep dimensions to trajectory group membership; and, the development, implementation and efficacy of a sleep education pilot intervention designed to promote sleep health and reduce the likelihood of depressive symptoms throughout pregnancy. Findings from the scoped review showed that while sleep in pregnancy is highly variable from one woman to the next, significant changes to sleep throughout pregnancy were not indicated for women who were considered physically and mentally healthy. However, the results of the longitudinal analysis revealed that for a sub-group of women, poor sleep was significantly associated with clinically elevated and persistent depressive symptoms throughout the perinatal period and into their child’s preschool years, with the probability of experiencing depressive symptoms especially pronounced for Māori women. The Sleep HAPi pilot study found recruiting and retaining previously depressed women into a longitudinal perinatal sleep education study achievable and the study design highly acceptable to participants. Similar to the results of the scoped review, self-reported sleep duration, quality, timing, continuity and daytime sleepiness remained stable throughout pregnancy, and at intervention end none of the women in this study were experiencing clinically elevated depressive symptoms. Sleep HAPi women were compared to a control group from a previous study with no sleep education component; Sleep HAPi mothers had significantly better sleep initiation and experienced fewer depressive symptoms at intervention completion, though results require confirmation in a larger randomised control group study. Collectively, the findings from these studies highlight the strong relationship between sleep and maternal mental health. Sleep education interventions, such as Sleep HAPi, show promise for minimising depressive symptoms, and optimising sleep for pregnant women. These findings have important health care practice and policy implications and the potential to improve outcomes for mothers, children, families and society.
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    Finding a treatment that fits : a grounded theory study of women's compliance with treatments for depression using a community sample from dietary intervention study : a thesis presented in partial fulfilment of the requirements for a degree of Master of Arts in Psychology at Massey University, Palmerston North, New Zealand
    (Massey University, 2003) Hamilton, Frances Catherine
    Compliance with healthcare regimens is becoming an increasingly important area of health research. Depression is thought to be increasing in prevalence world-wide, and so too is the share of the healthcare budget dedicated to treating depression. Research has shown that people tend to discontinue treatments for depression far earlier than recommended. However, very little research has explored why this might be so. Several theories of health behaviour have tried to account for compliance in terms of influential beliefs and attitudes, but generally these theories have not been explored in a mental health context. Additionally, research is only just beginning to consider compliance from a healthcare consumer's perspective. The Compliance Study reported in this thesis adopted a grounded theory methodology to explore compliance with women's treatments for depression. A community sample of 37 depressed women, participating in a 12 week double-blind placebo controlled trial investigating the effects of fish oil as an adjunct to treatments for depression, provided both qualitative and quantitative data on their compliance experiences with treatments for depression generally, and with the supplement trial specifically. The basic social process of compliance that emerged from the data involved a complex and dynamic interaction of mutually influential illness variables, significant relationships, meanings given to depression and its treatments, and cost-benefits analyses. In Finding a Treatment that Fits, women balance competing interests and try to ensure good enough compliance to meet their own goals for wellness. The results from the Compliance Study confirmed important prior findings with respect to compliance with depression treatments, but extended these by looking at underlying reasons for decisions to continue or discontinue treatments. The thesis also considers special issues relevant to the particular circumstances of compliance in the dietary intervention trial, including the impact of placebo effects and attitudes towards non-orthodox treatments. Implications for further research and clinical practice are discussed.
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    Korean female immigrants' lived experience with depression : a phenomenological study : a thesis presented in partial fulfillment of the requirements for a Masters of Philosophy in Psychology at Massey University
    (Massey University, 2002) Lee, Simon Seung Wook
    The aim of this study lies in describing and interpreting the meanings of Korean female immigrants' lived experience of depression. Depression is the most frequently occurring mental health diagnosis amongst immigrants. Waves of Korean immigrants have flocked to New Zealand for the last decade, and now the Korean language is the most common language after English in North Shore city. It is believed that a study on Korean female immigrants' mental health needs to be addressed by clinical professionals and mental health workers. Six Korean females who had lived for more than one year in New Zealand, and had once experienced depression were voluntarily selected and interviewed. The data was analysed by the following hermeneutic framework. The first chapter states the justification and impetus of the study, and the position of the researcher. It also contains an explanation about the focus and objectives of the study. The second chapter is dedicated to offering an opportunity to understand Korean culture in relation to the study's aim. The main social philosophy, religion, and norms are introduced to provide the reader with a better picture of Korean culture. The third chapter presents philosophical guidance for a hermeneutic study, and discusses how the framework has been applied to the study. The process of collecting and analyzing data and the ethical considerations that protect the participants' human rights and dignity are the main focus of this chapter. The findings section discusses four main themes which were classified to capture the core meaning of the participant's experiences. The last chapter discusses the limitations and recommendations that have emerged from the study. Notes Italics: The interview data from the study participants Names: Pseudonyms in Korean are used to protect the clients' anonymity. As English is not my first language, my proof readers, Emma and Leisa helped considerably to change my English into grammatically correct written English.
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    Context matters : women's experiences of depression and of seeking professional help : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Albany, New Zealand
    (Massey University, 2012) Batten, Jodie Anne
    Most existing research on women and depression takes a realist approach that effectively silences the voices of women and limits our understandings of depression. By engaging with the stories of seven women, recruited from a provincial New Zealand area, this research privileges women's voices. Taking a discourse analytic approach, this research explores how women construct their experiences of depression and of seeking professional help. I take a micro discursive approach in identifying how the women utilise various discursive resources in constructing their accounts of both depression and of seeking professional help. In order to locate these discursive resources within the broader socio-cultural environment, I employ a macro discursive approach drawing on Foucauldian discourse analysis and Davies and Harré’s Positioning Theory. Participant’s accounts of their depressive experiences change over the course of their journeys. I explore how the women's accounts shift from a contextualised explanatory framework that locates their experiences of depression within the gendered context of their lives, to a medicalised explanatory framework as they enter the professional help arena. This research offers insights into how dominant discursive construction of the ‘good’ woman/mother dovetail with a biomedical explanation of depression and prevailing discursive constructions around anti-depressant medications. Working together, these discourses effectively silence women's voices, both pathologising and decontextualising women's depressive experiences. Furthermore, I suggest that these dominant discursive resources and practices offer limited ways for women to make sense of their experiences in meaningful and empowering ways. A need for new understandings about women and depression is called for - one grounded in the material-discursive realities of women’s gendered lives.